[Spontaneous hepatic rupture of pregnancy. A report of four cases and medical literature review].

The spontaneous liver rupture associated with preeclampsia is a potential life threatening condition that requires a multidisciplinary team approach. There are near 200 cases reported in the world literature. This paper presents four cases of liver rupture associated with preeclampsia, three of which were consecutive with only two days apart, describing the clinical features and the therapeutic approaches. We also discussed about the mortality, which occurred in one of our cases, and perinatal mortality that affected one newborn and another one had neonatal encephalopathy secuelae. Three of the cases were managed in a surgical manner, one of them also with selective hepatic artery embolization meanwhile another one received conservative management. It is important to suspect this pathology in the preeclamptic patient, especially if she develops HELLP syndrome, in order to establish opportune diagnosis and treatment with a team including the intensive care, surgery and obstetrical staff.